Introduction:Numerous studies have evaluated the efficacy and safety of
varenicline for smoking cessation in smokers in the general population and,
to a lesser extent, among the psychiatric population. However, few studies
have evaluated varenicline in patients with other addictions. The present
study was conducted to assess outcomes of a multimodal treatment for
smoking cessation intervention with varenicline in a sample of alcohol and
substance use disorders and patients with psychotic disorders.

Methods:This was a prospective, multicenter study. The patient sample
comprised alcoholics in remission, methadone-maintained patients, and
patients with psychotic disorders, all of whom wanted to stop smoking. All
participants received multimodal treatment for smoking cessation therapy
(psychological therapy plus varenicline). Smoking abstinence and changes
in the psychopathological state of patients were assessed at predefined time
points during a 12-month follow-up. The probability of tobacco abstinence
after one year of treatment was computed using Kaplan-Meier life tables.

Results:The probability of abstinence at one year was 0.225 (95% CI: 0.143-
0.319). By group, the probabilities were as follows: patients with psychotic
disorders 0.254 (95% CI: 0.118-0.415); alcoholics 0.237 (95% CI: 0.098-
0.409); and methadone-maintained patients 0.177 (95% CI: 0.065-0.335).
Patients with previous quit attempts had a higher probability of achieving
abstinence at one year (p<0.01).

Conclusions:The results of this study support the use of multimodal treatment
with varenicline in patients with alcohol addiction in remission, patients
on methadone maintenance, and patients with stable psychotic disorders.
Previous smoking cessation attempts were predictive of smoking cessation
success in these patients.

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Benli AR, Erturhan S, Oruc MA, Kalpakci P, Sunay D, Demirel Y. A comparison of the efficacy of varenicline and bupropion and an evaluation of the effect of the medications in the context of the smoking cessation programme. Tobacco Induced Diseases. 2017;15(February). doi:10.1186/s12971-017-0116-0